Heart disease remains the leading cause of death in the United States, affecting nearly 800 million people. Annually, coronary bypass surgeries are required in approximately 250,000 patients, over 50,000 patients are diagnosed with end-stage renal disease, and another 8 million are diagnosed with peripheral arterial disease.
Congenital heart disease is the most common birth abnormality in humans and affects almost 1% of all live births. Approximately 25% of these patients have critical congenital heart disease and require surgical or percutaneous cardiac intervention within the first year of life for survival. Congenital heart disease manifests as a wide variety of structural malformations; due to the diversity of abnormalities, there are various options for palliation and correction.
Vascular grafts are integral to treating aneurysms, vascular reconstruction, congenital cardiovascular disease, and organ transplantation. While autografts may be used as a gold standard, vessel availability may be limited by existing disease conditions or prior surgeries. Investigation of potential synthetic grafts have largely supported the application of poly(ethylene terephthalate) (PET) and expanded poly(tetrafluorethylene) (ePTFE) grafts in large-diameter (>6 mm) applications. However, grafts for small diameter (<6 mm) applications continue to be challenging because of graft failure due to stenosis.
Tissue engineering approaches offer a potential solution to these challenges. Thus, biodegradable vascular grafts have been constructed from biological and synthetic materials. Small-diameter vascular grafts, however, have experienced a myriad of complications ranging from thrombus formation, aneurysms, intimal hyperplasia, calcium deposition, and noncompliance leading to low patency rates and graft failure.